A hysteria has swept the country.
When a militant advocate of vaccination – vaccination, by force, if necessary – calls someone who does not automatically agree with them anti-vax, the implication is clear for all observers of the debate. The “anti-vaxer” does not see any value in vaccinations. He does not realize that vaccinations have helped eradicate disease in the past. He does not agree that vaccinations are a feat of modern medicine. In short, he is in denial of reality and history and, worst of all, ANTI-SCIENCE!
Whatever that means in the 21st century. (You think science doesn’t exist? You didn’t like your high school chemistry class?)
I am a scientist, so I think that means that the label anti-science won’t stick to me. It is true: I am enamored by true modern medicine miracles. Vaccines are one outcome of the amazing advances in science and medicine. I believe that, while Dissolving Illusions: ... Best Price: $38.50 Buy New $21.60 (as of 11:00 UTC - Details) we may never achieve immortality through medical advances, there is a seemingly limitless list of diseases that man will one day understand to the extent that it could be conquered. The biomedical sciences have an extremely optimistic outlook in terms of the knowledge that it will continue to gather.
So let’s look at some reality, history and science of measles.
A brief history of the measles vaccine
When the measles vaccine was developed in the 1960’s, parents and doctors who had earlier embraced the polio vaccine, were not entirely convinced that a measles vaccine was necessary. Ultimately, the organized vaccination efforts got to work, and we children of the 70’s were vaccinated against the measles. Because some of the vaccines were live attenuated viruses, some of us (like my sister) caught the measles from the vaccine.
The mumps and rubella vaccines were developed around the same time as the measles vaccine. Mumps and measles were common diseases that were starting to get some public support for vaccines. The rubella vaccine was a tougher sell, and it was yet another shot. In order to get rubella vaccines to be more accepted by doctors and patients, they created the combination Measles-Mumps-Rubella vaccine, MMR. Thus, by the late 70’s, a child would get the oral polio vaccine plus 2 Against the State: An ... Best Price: $5.02 Buy New $5.52 (as of 11:35 UTC - Details) shots (Diptheria-Tetanus-Pertussis vaccine and MMR). We all initially received one measles shot (either as the single vaccine or MMR), sometime before or during our early elementary school years. I remember getting my shots and drinking my pink polio vaccine, but here’s an official history of vaccine schedules to confirm. Clearly, I was not only 1 year old when I was vaccinated.
As daycare and preschool attendance was on the rise, it was soon clear that the age of vaccination needed to be moved up, because they were unable to eradicate the disease. It continued to pop up, year after year, shared by the best germ sharers we all know: 3 year olds in crowded childcare settings. Curiously, the 3 year olds were also sharing the measles with older children who had been vaccinated. Ultimately, the vaccine was approved for use in 1 year olds, and a booster shot was added.
This article is not about vaccines in general, but I will digress a little in that direction at this point. As stated, starting in the late 70’s, a child would get 2 shots and an oral vaccine, sometime around the age of 5. This was 7 vaccines total in 2 pokes and one drink. That was it.
…Until we needed stitches or broke a bone sometime in our teens, and a booster Tetanus shot was administered. (I had a very stiff arm for my 12th birthday roller-skating party. Ouch!) Saying No to Vaccines:... Best Price: $80.90 Buy New $210.95 (as of 08:35 UTC - Details)
Children of the 70’s and 80’s are today’s parents. We are being told by the healthcare policymakers that our children need to get…actually I’m not really sure. I have my own children and I have to look this up every time. There’s a chart you can try to interpret here [pdf]. It looks like 25 or so shots before the age of 2, with one of those shots being recommended on the day of birth. (I do know that they don’t get to drink any vaccines anymore…I would have noticed that!) That covers a total of 14 different diseases, many of which I had to look up when I became a parent because I had never heard of them before, or knew very little about them.
So, my digression leads to this: It is kind of suspicious that pretty much everyone I know from childhood survived to be an adult (and I can’t think of one that died from a communicable disease), but my children need to be vaccinated against 14 diseases by the time they are 2. I don’t think that questioning the official vaccine schedule makes someone an anti-science, “anti-vaxer,” who should be fired by their pediatrician. On the contrary, I think it shows that they are thinking a little more deeply about their child’s health, and the medical community should respectfully discuss these questions with them. And, you know, maybe one-size doesn’t fit all.
Is measles contagious? Yes, very much so. As this 2004 review by Orenstein, et al, relays, the vast majority of pre-1960 American children caught the measles. When something infects more than 90% of the population, it is very contagious How to Raise a Healthy... Best Price: $1.99 Buy New $4.19 (as of 07:30 UTC - Details) indeed.
Has the existing measles vaccination program worked? Again, this is a resounding “Yes.” Orenstein, et al, state,
Measles is no longer endemic in the United States . Since 1997, the reported annual incidence has been <1 case/1 million population. The majority of cases are international importations or the result of limited domestic spread following imported cases. All other cases in recent years are believed to be due to unidentified importations.
Patient zero in the recent Disneyland outbreak was almost certainly a foreign visitor. Because measles has not existed in the United States for at least fifteen years.
But isn’t there an alarming rise in people who don’t vaccinate for measles in California? No. California has a very high vaccination rate. Children in daycare are currently vaccinated at a level of at least 96.1% [pdf] (specifically MMR). This is an increase of 0.3% over the previous school year.
Is measles deadly? Usually not, but sometimes it is. The mortality rate in developed countries, pre-vaccine, was about 0.1%. Research supports the conclusion that half of these deaths occur in people who are already in bad health. NOW Supplements, Vitam... Buy New $9.70 (as of 10:49 UTC - Details)
As Ryan McMaken has pointed out, 1960s-era medicine was sufficient to treat the vast majority of measles cases successfully. I wonder what medicine that has had another half-century of development would be capable of in terms of measles mortality. It appears to have been halved from 1 death per 1000 cases to 1 death per 2000 cases. Specifically, In 2012, the UK had a reported 2092 measles cases, but only one death (an adult over 15 years of age). I doubt that my calculation is statistically significant, but measles is so rare in the US and UK that the best we can do is guess.
Does measles cause blindness? Not in developed countries. For example, a survey of complications of measles in England in 1963 [pdf] by D. L. Miller did not list blindness (although eye infections did occur in an extremely small number of cases). A search of Pubmed seems to indicate that measles-linked blindness is correlated to vitamin A deficiency, and occurs in countries where malnutrition is common.
Does measles cause encephalitis (brain inflammation)? Usually not, but sometimes it does. The rate of “encephalitis or impaired conciousness” in Dr Miller’s 1963 study was 0.061%. Interestingly, no infants, and very few young children suffered from encephalitis. Children and adults over age 10 were those primarily afflicted. (The primary complications experienced by babies were respiratory problems such as pneumonia and bronchitis. Respiratory complications were much less common in older children.)
Did the unvaccinated cause the Disneyland epidemic? From a statistical point of view, unvaccinated individuals undoubtedly played a role in making the epidemic worse, but there will be measles outbreaks in the US as long as there are measles outbreaks in other countries no matter what the vaccination rate is. The recent outbreak was almost certainly imported into the country, not home-grown (in an unvaccinated west-coast fundamentalist commune, I suppose?). To quote from a CDC/WHO report [pdf]: Lypo-Spheric Vitamin C... Buy New $32.95 (as of 10:05 UTC - Details)
In a highly immunized population, a large proportion of cases is expected among immunized persons, since there are so few unimmunized persons. For example, if 98% of the population is immunized with a vaccine that is 95% effective, 71% of cases are predicted to occur among vaccinated persons.
The vitriol being hurled at people who opt-out of vaccinating might have you thinking otherwise, though.
None of the above is meant to minimize the seriousness of death, brain inflammation, or a number of other rare, but serious, complications that can be caused by measles. These things are terrible for the patient and for their loved ones, and I don’t think there is anyone who would say otherwise. I bring it up so that the facts are straight. No scare tactics. The facts are scary enough for most people. So why do militant vaccination advocates use distorted “stats” that are even scarier? Why quote the number of people who die every minute, worldwide from measles? Why point out complications that were never really an issue for Americans?
The reason for exaggerating the seriousness of what used to be a run-of-the-mill children’s illness is because this has never been about what is best for the individual. Top-down vaccination programs have always been about what is “best” for society. This is why force and propaganda are needed. You do not need to coerce and intimidate people into making good personal choices for themselves and their children. On the flip side, coercion and intimidation are needed to get people to make choices that are better for other people, particularly if they have little positive effect – or a perceived negative effect – on themselves. These are the tools of bullies. Check Amazon for Pricing.
The truth is, the number one, best predictor for how bad a case of measles will be is: Standard of living.
So, is the solution to fighting terrible diseases (or not-so-terrible diseases), to crack-down on personal exemptions to vaccinations? Is it to jail parents who decide against MMR? Is it to create a public database of all non-vaccinated people? Is it to file criminal charges against anyone who catches measles, and therefore becomes contagious?
I posit that, at a minimum, nothing should be changed. Enacting new laws will provide an exceedingly small amount of additional “herd immunity” in a country that already has herd immunity. The costs, however, are substantial. We will allow our fears – however unlikely – to once again trump very basic civil rights.
When the terms of the debate have already been established as the individual is meaningless and unimportant, and the good of the whole (community, country, or even world) is the only important, worthy, and valid goal, then the prospect of protecting individual rights is automatically outrageous. But a strong respect for individual rights is precisely what will save the world from debilitating and deadly complications of measles.
So there is something to be done: embrace capitalism here at home, and engage in peaceful trade worldwide.
The surest thing to save peoples suffering from measles in developing nations is to increase their standard of living. The industrial revolution has literally saved our lives, by making modern medicine and good nutrition abundant and affordable. The very opposite of forced vaccinations – namely, liberty – made us rich enough to live longer lives than man has ever lived before. And liberty can make the rest of the world that rich, as well.